Reharvest of iliac crest donor site cancellous bone

Patients requiring cancellous bone grafting of an extensive deficit or multiple bone grafting procedures often lack a sufficient quantity of autogenous cancellous bone. Canine studies have indicated that a potential exists for reharvesting autogenous cancellous bone from an iliac crest donor site using a trapdoor harvesting technique. However, significant human experience with this procedure has been lacking. This report describes four patients who underwent successful reharvesting of an iliac crest donor site that provided clinically sufficient autogenous cancellous bone graft material to treat an ongoing or a new skeletal problem. These patients all met specific criteria regarding use of the trapdoor method of bone graft harvest and a minimum 24-month interval between bone grafting procedures. Preoperative computed tomography scanning of the iliac crest was useful in documenting that sufficient cancellous bone was available for reharvest. It appears that iliac crest donor site reharvesting is a specific advantage of the trapdoor technique and is a possible alternative to multiple site grafting or the use of allograft or bone substitute materials.